"Critics of EEG neurofeedback hold this treatment to more rigid standards than many of the drug treatments," David F. Velkoff, M.D., medical director of the Drake Institute of Behavioral Medicine in Los Angeles, who has treated over 1,000 patients with neurotherapy, told the press. "Yet unlike drugs, neurofeedback is benign." According to Frank H. Duffy, M.D., associate editor for Clinical Electroencephalography, any pharmaceutical drug that had as wide a range of effectiveness as neurofeedback would be universally accepted and widely used (Duffy, 2000).
Although neurofeedback remains an investigational therapy (Baydala and Wikman, 2001), the growing number of case studies on this therapy are compelling enough to warrant controlled clinical trials with adequate sample sizes that can generate replicable data. "Alternative research designs involving sham neurofeedback are already in use as well as comparative investigations of neurofeedback with both conventional treatments and with combined treatments consisting of neurofeedback and psychostimulants," according to Lubar. "The Association for Applied Psychophysiology and Biofeedback [AAPB] is currently developing application standards for ethical controlled studies of neurofeedback that simultaneously protect patients and the integrity of research investigations."
In summary, preliminary evidence suggests that psychopharmacological and electrophysiological approaches to the treatment of mood and behavioral disorders are not intrinsically contradictory. Neurofeedback is perhaps best viewed not as an alternative to conventional psychopharmacological agents, but rather as one component of a multimodal approach. When used as an adjunctive treatment in combination with standard medication, neurofeedback may improve certain clinical outcomes in some psychiatric patients.
Alhambra MA, Fowler TP, Alhambra AA (1995), EEG biofeedback: a new treatment option for ADD/ADHD. Journal of Neurotherapy 1(2):39-43.
Baehr E, Rosenfeld JP, Baehr R (1997), The clinical use of an alpha asymmetry protocol in the neurofeedback treatment of depression: two case studies. Journal of Neurotherapy 2(2):12-27.
Baydala L, Wikman E (2001), The efficacy of neurofeedback in the management of children with attention deficit/hyperactivity disorder. Paediatrics and Child Health 6(7):451-455.
Duffy FH (2000), The state of EEG biofeedback therapy (EEG operant conditioning) in 2000: an editor's opinion. Clin Electroencephalogr 31(1):V-VII.
Gruzelier J (2000), Self regulation of electrocortical activity in schizophrenia and schizotypy: a review. Clin Electroencephalogr 31(1):23-29.
Hansen LM,Trudeau DL, Grace DL (1996), Neurotherapy and drug therapy in combination for adult ADHD, personality disorder and seizure disorder: a case report. Journal of Neurotherapy 2(1):6-14.
Kaiser DA, Othmer S, Scott WC (1999), Effect of neurofeedback on chemical dependency treatment. Presented at the American Association for the Advancement of Science Annual Meeting and Science Innovation Exposition. Anaheim, Calif.; Jan. 21-26.
Lubar JF (1997), Neocortical dynamics: implications for understanding the role of neurofeedback and related techniques for the enhancement of attention. Appl Psychophysiol Biofeedback 22(2):111-126.
Lubar JF, Swartwood MO, Swartwood JN, O'Donnell PH (1995), Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in T.O.V.A. scores, behavioral ratings, and WISC-R performance. Biofeedback Self Regul 20(1):83-99.
Manchester CF, Allen T, Tachiki KH (1998), Treatment of dissociative identity disorder with neurotherapy and group self-exploration. Neurotherapy 2(4):40-52.
Moore NC (2000), A review of EEG biofeedback treatment of anxiety disorders. Clin Electroencephalogr 31(1):1-6.
Nash JK (2000), Treatment of attention deficit hyperactivity disorder with neurotherapy. Clin Electroencephalogr 31(1):30-37.
Othmer S (1999), Brain waves and brain states. California Biofeedback Society Newsletter Spring.
Othmer S (2000), Right side training for social-emotional deficits. California Biofeedback Society Newsletter Winter.
Othmer S (2001), Neurofeedback for the bipolar child. Paper presented at the Society for Neuronal Regulation Annual Conference. Monterey, Calif.; Oct. 27-30.
Othmer S, Othmer SF, Kaiser DA (1999), EEG biofeedback: an emerging model for its global efficacy. In: Introduction to Quantitative EEG and Neurofeedback, Evans JR, Abarbanel A, eds. San Diego: Academic Press, pp243-310.
Rosenfeld JP (2000), An EEG biofeedback protocol for affective disorders. Clin Electroencephalogr 31(1):7-12.
Rossiter TR, La Vaque TJ (1995), A comparison of EEG biofeedback and psychostimulants in treating attention deficit/hyperactivity disorders. Journal of Neurotherapy 1(1):48-59.
Swingle PG (1998), Neurofeedback treatment of pseudoseizure disorder. Biol Psychiatry 44(11):1196-1199.
Thomas JE, Sattlberger E (1997), Treatment of chronic anxiety disorder with neurotherapy: a case study. Journal of Neurotherapy 2(2):14-19.
Trudeau DL (2000), The treatment of addictive disorders by brain wave biofeedback: a review and suggestions for future research. Clin Electroencephalogr 31(1):13-22.